24 Hour ECG Clinical Guidance - Firth Park Surgery

Author: Firth Park Surgery

Date published: October 2018

Date to review: April 2024


400 Firth Park Road, Sheffield S5 6HH

Telephone: 0333 3232900

Fax: 0114 2421966

Dr Joanne Hopkins • Dr Robert Corker • Dr Ruth Tupper

Dr Angela Kirby • Dr Luqman Ahmed

Practice Manager – Tracey Dunbar

Primary Care Based 24hr ECG AQP Cardiology Diagnostics Guidance

The Service Proposed

This service will enable GPs to directly access 24 hr ECG monitoring within a Community

base. This will allow patients with low risk of significant cardiac pathology who are suffering

from palpitations/suspected clinically significant arrhythmia.

Stage 1 – The consultation

It is up to the patients GP to determine whether the patient has a level of risk which requires specialist assessment, if the patient is experiencing palpitations less frequently than daily, then they should be considered by their GP for loop event recorder investigation.

Low Risk group

Patients who fulfil the following criteria should initially be treated conservatively:

· No history of sustained tachycardia or loss of consciousness AND

· Good exercise capacity AND

· No family history of Sudden Cardiac Death < 40 years AND

· Normal cardiac examination

Before referral to the 24 hour ECG Service, a resting 12-lead ECG and appropriate blood tests should be carried out. PLEASE LET THE PATIENTS KNOW THAT THEY CANNOT HAVE A SHOWER WHEN THE LEADS ARE FITTED AND THAT THEY SHOULD NOT TRY AND REMOVE THE LEADS DURING THIS PERIOD.

Stage 2 – referral to local service provider for 24-hour ECG investigation

Referrals to Firth Park Surgery will be made using the referral form on the Press Portal or Via ERS, Our HCA at Firth Park Surgery will fit the patient with the device and provide the patient with a patient information leaflet, care of ECG monitor form, and their contact details should any problems/concerns arise. We will advise the patient on the time to return the device the following day to the surgery.

Stage 3

The HCA will download the recordings and send the recording to Express diagnostics over a secure encrypted internet link, the file itself is also encrypted and can only be read by an Express Diagnostics consultant.

Stage 4

Express Diagnostics analyse the recording and then send the PDF report directly to the referring practice via a secure NHS.net Account.

Stage 5

The patient is informed of the results by their registered practice and managed as appropriate.


We will attempt to contact the patient and rebook, If we are unable to contact the patient, the referring practice will be notified.